Initial prevalence and progression of multifocal atherosclerosis were evaluated after 1 year of old myocardial infarction with ST segment elevation (STEMI). 168 patients with STEMI were investigated. All patients underwent coronary angiography, angioplasty with stenting of infarction-related artery and screening for non-coronary atherosclerosis of brachiocephalic and lower limb arteries. Observation lasted for 12 months. 92% of patients with STEMI in hospital period were characterized by different symptoms multifocal atherosclerosis; after 12 months of observation non-coronary stenoses of various degrees were observed in 100% of patients. In most patients (up to 87%) with progression of non-coronary atherosclerosis target levels of lipid profile were not achieved. Relationship between progression of multifocal atherosclerosis and unfavorable long-term prognosis due to acute strokes was estimated. It is drawn a conclusion that progression of multifocal atherosclerosis (initially revealed in 92% of patients) is estimated in more than 70% of patients by 12 months after STEMI in absence of effective treatment with statins increasing the possibility of unfavorable long-term prognosis.